Sociological and anthropological factors related to the community management of tuberculosis in the Western Cape communities of Ravensmead and Uitsig

Abstract

Objective: To determine the sociocultural understanding of tuberculosis among patients and their household members.

Design: Qualitative descriptive study.

Setting: Two adjacent Western Cape suburbs with a population of approximately 35,000, a tuberculosis incidence of > 1,000/100,000 and a surface area of 2.42 km2.

Subjects: Twenty-three adult patients on treatment for tuberculosis and their adult household members.

Interventions: None.

Methodology: Consecutive selected adult tuberculosis patients and their household members were interviewed with an open-ended interview schedule. General household and community conditions and non-verbal responses were recorded.

Results: There were relatively affluent but also severely deprived households with severe overcrowding. Substance abuse was common. Patients had limited understanding and knowledge about health, hygiene and the cause of tuberculosis. There was a perception of both physical and social distance between patients and health care providers. All patients relied exclusively on the conventional biomedical curative approach of the medical system to deal with tuberculosis.